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Heart Failure

Mar 19, 2012 , Translated by Kristina Knazko

Heart failure is a serious illness based on the malfunction of the heart’s role as a pump. Heart failure is divided according to how quickly it develops and how long it lasts, as acute heart failure and chronic heart failure. Heart failure can have a number of causes such as myocardial infarction, arrhythmia, or chronic stress on the heart due to hypertension. Untreated heart failure significantly shortens the life of the affected patient and decreases its quality.

Heart Failure

Heart failure is a condition where the heart stops pumping blood due to various reasons. Under normal conditions, blood from the whole body flows through the superior and inferior venae cavae into the right atrium. From here, the blood flows into the right ventricle, which expels it into the lungs. Here the blood is oxygenated and returned to the heart through the left atrium and left ventricle. The left ventricle's contractions pump the blood into the rest of the body. The heart as a whole functions correctly only in the event that the pumping mechanism of the right and left ventricles is not damaged.

The Essence of its Failure

Heart failure is the result of many various diseases and conditions. According to how quickly the heart is failing, acute and chronic heart failure can be distinguished.

Acute heart failure occurs quickly and suddenly. It can develop as a consequence of myocardial infarction, the most common cause. Sudden severe arrhythmia or the presence of blood clots in the pulmonary arteries can also be causes of acute heart failure.

Chronic heart failure develops slowly, often over the course of several years. The human body is very adaptable, therefore the heart is able to adapt by distending or increasing the strength of its contractions, until the gradual failure of this organ. Ischemic heart diseases are common causes; a result of fat collecting on the walls of blood vessels, causing a poor supply of oxygenated blood to the heart. Equally common causes of chronic heart failure are high blood pressure or other heart conditions and diseases such as cardiomyopathy.

The Main Symptoms of Heart Failure

Symptoms of heart failure depend on what part of the heart is affected, whether it is the right or the left ventricle.

When the right ventricle is failing, blood stasis occurs in the veins, leading to an enlarged liver. The patient may feel this as pain under the right ribcage. Other symptoms include swelling of the lower limbs. Swelling typically begins around the ankles and gradually spreads upwards. Before the swelling appears, the patient may experience increased body mass, which is often not seen as a significant sign.

In the case of the failure of the left ventricle, blood accumulates in the lungs. This is manifested by shortness of breath occurring mostly at night, when the patient with heart failure tends to sleep in a half sitting positions due to discomfort. Because the blood accumulates in the lungs, less of it reaches the body. This results in insufficient blood supply to the muscles of the body, which can manifest itself as general fatigue. Some symptoms of heart failure are seemingly unrelated, such as kidney dysfunction, which can cause reduced urine output, among other things.

Diagnosing Heart Failure

The basic prerequisite for correct and effective treatment of heart failure is a prompt visit to the doctor in the event of the above mentioned symptoms. A detailed medical history, physical examination, and other instrumental diagnostic methods can detect heart failure. A basic diagnostic method for heart failure is an electrocardiogram, EKG or ECG. This is a painless examination where with the help of electrodes attached to the limbs and chest, electrical activity of the heart is monitored and recorded on paper in the form of curves and waves. A lung x-ray and blood tests are also necessary. An ECHO, echocardiograph, is also significant as it is an ultrasonic examination of the heart. It provides information about the size of the heart's chambers, the state of the valves and the mobility of the heart muscle. If the coronary arteries supplying the heart need to be viewed, a selective coronary angiography can be performed, where these vessels are injected with a contrast agent.

Treating Heart Failure

Treatment of heart failure is based on diet. Salt intake must be limited. Physical activity is recommended of course, within the means of the patient. Pharmacotherapy plays a significant part in the treatment of heart failure. Beta-blockers, which lower heart rate, are prescribed, as well as diuretics and antihypertensives to lower high blood pressure. Treatment is typically long-term and medications need to be taken for the rest of the patient's life. In some cases, heart failure can be treated with surgery by performing a bypass or valve surgery. In the case that arrhythmia is the cause of heart failure, antiarrhythmics can be administered or a defibrillator can be implanted. A defibrillator is a device able to detect heart rhythm disorders and shock the heart's rhythm back to normal. An extreme method of treating heart failure is a heart transplant.

Preventing Heart Failure

Heart failure, despite quality and modern treatment, is still the leading cause of death in the USA and many other developed countries. This can be due to a lack of prompt care during acute heart failure, or the fact that chronic heart failure can go unnoticed for a long time. This is because it may not have any manifestations. Another problem is the patient's cooperation, as patients often do not take enough care with their treatment. In order to improve the alarming healthy statistics, every person can contribute by putting effort into improving one lifestyle choices. Preventing the causes of heart failure greatly relies on every individual.

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